Separation of the fifth toe from the rest of the foot.
The cause is usually traumatic although it may be secondary to elective surgery.
When amputation is performed in the context of surgery, blood vessels are tied off to prevent bleeding before bone and muscle are cut. The most frequent causes are diseases that cause poor blood circulation such as diabetes, tumours, deformities, infections and/or gangrene.
When amputation occurs in the context of trauma, the bleeding and tissue loss is usually greater. When the limb is torn off or avulsed, bleeding can be massive and surgical repair very difficult. The most common causes are traffic accidents, industrial accidents and war injuries.
The treatment of choice is surgical and the priority is to save the finger if possible and to avoid bleeding and infection. Severe cases can lead to death of the patient if not controlled.
In cases of traumatic amputation, direct compression may be used to reduce bleeding until surgical revision is performed. If the amputated finger and stump receive appropriate care, reattachment of the amputated finger and stump can be considered in a specialised centre.
- Antevy, PM, Saladino, RA. Management of finger injuries. In: Textbook of Pediatric Emergency Procedures, 2nd edition, King, C, Henretig, FM (Eds), Lippincott, Williams & Wilkins, Philadelphia 2008. p.939.
- de Alwis W. Fingertip injuries. Emerg Med Australas 2006; 18:229.
